In Turkey, rhinoplasty is the most common operation in the field of facial plastic surgery and has gained increasing popularity especially within the past decade. There are many reasons for this increase. First, traditional Turkish noses are usually big, with humps of varying degrees. Second, image has become very important, especially among younger adults (those aged 18 to 25 years). Third, the number of surgeons performing this operation in Turkey has increased exponentially within the past decade. Fourth, the costs of the operation have also decreased, so rhinoplasty is no longer an operation only for rich people in Turkey.
Turkey has about 72 million inhabitants, and it is estimated that there are an additional 5 million Turks living outside the country. Throughout history, this region has been a cradle of many civilizations and a melting pot for people from many countries. Therefore, although it is almost impossible
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Friday, November 20, 2009
Monday, November 9, 2009
Rhinoplasty Risks
Although rhinoplasty is a very common surgery, there are nevertheless risks that should be taken into account by anyone considering the procedure. The dangers of rhinoplasty - such as permanent nerve damage after rhinoplasty - are few, but like every invasive procedure, rhinoplasty will always have its potential problems. Fortunately, most nose surgery procedures are problem-free, but patients should educate themselves on potential nose job risks and speak with a surgeon before moving forward with the procedure.
Risks Associated with Rhinoplasty Surgery
There are risks associated with any surgery, such as bleeding, infection, adverse reaction to anesthesia, and hematoma (when blood collects under the skin; a hematoma has to be removed surgically).
The specific dangers of rhinoplasty/nose surgery include numbness, nosebleeds, scarring at the base of the nose (this may occur when the nose surgery is an "open rhinoplasty"), bursting of small blood vessels on the surface of the skin, swelling, permanent nerve damage after rhinoplasty, or under- or over-correction that necessitates secondary/revision rhinoplasty.
Before your nose surgery, you will consult with your doctor about the possible risks; the doctor will also address any questions and concerns you may have. Following your surgeon's instructions for your pre- and post- nose surgery care will help to avoid almost any problem and greatly diminish the risk factors.
Nose Surgery Recovery and Problems with Depression
Immediately after their nose surgery, patients may feel discouraged with the results of their procedure. Because there can be considerable swelling, the initial effects of rhinoplasty may not be apparent for weeks and the final result may not be attained for many months. However, as the nose heals and the swelling subsides, most patients feel that their rhinoplasty goals have been achieved. Patience, a thorough understanding of the procedure, and allowing ample rhinoplasty recovery time are important for both surgical success and patient satisfaction. After the full recovery time, a patient will be better able to see the results of their much anticipated nose surgery, and will most likely be problem-free and very pleased with their new look.
SOURCE
Risks Associated with Rhinoplasty Surgery
There are risks associated with any surgery, such as bleeding, infection, adverse reaction to anesthesia, and hematoma (when blood collects under the skin; a hematoma has to be removed surgically).
The specific dangers of rhinoplasty/nose surgery include numbness, nosebleeds, scarring at the base of the nose (this may occur when the nose surgery is an "open rhinoplasty"), bursting of small blood vessels on the surface of the skin, swelling, permanent nerve damage after rhinoplasty, or under- or over-correction that necessitates secondary/revision rhinoplasty.
Before your nose surgery, you will consult with your doctor about the possible risks; the doctor will also address any questions and concerns you may have. Following your surgeon's instructions for your pre- and post- nose surgery care will help to avoid almost any problem and greatly diminish the risk factors.
Nose Surgery Recovery and Problems with Depression
Immediately after their nose surgery, patients may feel discouraged with the results of their procedure. Because there can be considerable swelling, the initial effects of rhinoplasty may not be apparent for weeks and the final result may not be attained for many months. However, as the nose heals and the swelling subsides, most patients feel that their rhinoplasty goals have been achieved. Patience, a thorough understanding of the procedure, and allowing ample rhinoplasty recovery time are important for both surgical success and patient satisfaction. After the full recovery time, a patient will be better able to see the results of their much anticipated nose surgery, and will most likely be problem-free and very pleased with their new look.
SOURCE
Tuesday, November 3, 2009
More on Rhinoplasty and Cosmetic Plastic Surgery Do-Over
NO face-lift stops time, so as aging continues, even a satisfied patient may choose to have another one a decade later. But what if your face-lift never pleased you, not because of complications or monstrous scars, but because of aesthetics pure and simple? Perhaps your first surgeon’s technique resulted not only in a tighter jaw line, but also a flat wind-swept cheek and a stretched mouth. Or your nose no longer has an unsightly bump, but now, postsurgery, is asymmetrical.
These days, there’s such a critical mass of plastic surgery patients dissatisfied with their results that many doctors market secondary surgeries, or re-dos. It’s not hard to find surgeons’ Web sites that describe in detail how an asymmetrical nose job or an unsatisfactory face-lift can be righted. Last month, Dr. Sam T. Hamra, a plastic surgeon in Dallas, published “The Facelift Letdown: When Results Don’t Meet Expectations” to arm patients with information so they can better articulate their desires to their doctors and avoid postsurgery discontent.
No organization tracks how many procedures are done to correct cosmetic work. (Muddying the situation is the fact that some doctors tweak their own work if it falls short of the patient’s goals and that some complications call for immediate reoperation, like a hematoma, or a collection of pooled blood, beneath a closed incision.)
In this still-shaky economy, cosmetic surgery is down, and revisions for unhappy patients are included in that slump. But doctors who do a lot of revision face-lifts and nose jobs (two common redos) say demand for those operations is still strong.
Reasons vary, depending on the procedure. Rhinoplasty, for instance, is tricky because surgeons can’t control healing or how good the building materials are. Cartilage can be too thick or too flimsy; skin draped over a newly fashioned nose structure might not shrink to the shape the surgeon wants.
“It’s a difficult operation with a lot of variables,” said Dr. James C. Grotting, the editor of the textbook “Reoperative Aesthetic and Reconstructive Plastic Surgery.” “So even in the best of hands, people who only do rhinoplasty,” he said, there is still “a revision rate of up to 20 percent.” Some of the best fix-it nose doctors are sober about the limitations. Dr. Mark B. Constantian, a nose specialist in Nashua, N.H., whose practice is 75 percent revisions, said rhinoplasty is unique in that “you can lose ground every time.” With other kinds of plastic surgery, patients “are not worse off than when they started.”
Some doctors refuse to tackle secondary or tertiary rhinoplasties, and sometimes patients seeking these operations get unfairly labeled as “a fussy neurotic group,” Dr. Constantian said.
He pinpointed four reasons for dissatisfaction: breathing is worse, which can happen if a doctor doesn’t compensate for aesthetic changes; postoperative deformity that patients don’t like (perhaps removing a bump leaves the patient’s nose crooked); the patient never reached the original goal; and last, the patient got the requested change but now finds it unacceptable. “After, they feel they lost a familial or ethnic characteristic, and ask, ‘Can you do something to put my nose back to what it was?’ ” he said.
One of Dr. Constantian’s revision patients, a nurse in New Hampshire, got her first rhinoplasty in 2004 to fix her nose’s too-wide tip and a hanging columella, the tissue on the underside between the nostrils. As the post-operation swelling subsided, “Everyday I would look and wait for changes,” said the nurse, who asked to remain anonymous. But the nose tip “was still wide” and the columella didn’t look “touched at all.” She searched on Google for nose specialists and found Dr. Constantian. Today her profile is straight, her columella no longer hangs, and she breathes better. “My breathing was never a problem until after the first surgery,” the nurse said.
Sometimes earnest miscommunication between patient and doctor is at the heart of the matter. “What the patient is seeing in their mind is hard to describe to the doctor,” said Dr. Jack P. Gunter, who devotes 40 percent of his nasal-surgery practice in Dallas to redos. “Patients will say, ‘I just want a little taken off.’ How much is a little?” Other doctors sweet-talk patients into thinking the perfect nose or face-lift is within reach, leading to discontent. “People are marketing things they cannot achieve,” Dr. Gunter said.
These days advertising creates unrealistic expectations, said Dr. Grotting, whose practice is in Birmingham, Ala. The idea that a procedure can be quick, simple, painless, “all of these catchphrases are heavily marketed to plastic surgery patients,” he said.
When it comes to plastic surgery, Dr. Hamra said, the “customer is always right.” A gynecology patient isn’t the one to determine if she wishes to spend less money to remove fewer of her uterine fibroids. A plastic surgery patient, however, can choose a minimally invasive face-lift instead of a more complete one, said Dr. Hamra, who favors comprehensive face-lifts that address upper cheeks and foreheads. If one surgeon won’t give him what he wants, the patient finds one who will.
Celebrity cases of too many face-lifts overshadow a common problem these days: paying thousands for small improvements that don’t last.
“In face-lifts, you see undercorrections,” said Dr. James M. Stuzin, a plastic surgeon who specializes in face-lifts in Miami and does a “big volume of redos.” Mini face-lifts, he said, require “little recovery,” but have “little longevity.” He also cautions that some surgeons who do only occasional face-lifting “don’t reconstruct the internal anatomy, and that has more longevity.”
In other words, you get what you pay for. “I’m seeing more people who have gone to clinics where price is a major concern for them going there, and often they are dissatisfied with the result,” said Dr. Stuzin, a past president of the American Society for Aesthetic Plastic Surgery. “Instead of muscle work, they are oversuctioning the neck, so the neck looks skeletal.”
Furthermore, not every plastic surgeon tailors his work to each face, but instead “do it the same way every day, and that doesn’t work for faces,” said Dr. Mark E. Richards, a plastic surgeon in the Washington, D.C., area. Patients have sought out Dr. Richards for revision face-lifts ever since Linda Tripp announced on TV that he redid her botched face-lift in 2000.
Other experts caution to be wary of the doctor whose technique is stuck in the dark ages. “There are still a lot of surgeons who just redrape the skin — that’s it,” Dr. Grotting said.
For decades, doing face-lifts hasn’t been about simply pulling the skin toward the ear. At the very least, underlying layers of tissue and fat should be repositioned; some doctors also try to restore the curves and volume lost to aging.
Lately, Dr. Richards says that he has found that many of his unhappy patients are missing “cheek curves.” Pulling the connective and fatty tissue layers just below the skin “doesn’t make an attractive face,” he said. “It just makes a tight face.”
Surgeons’ philosophies vary widely, so it’s crucial to meet with a few to ascertain which one will best achieve your goals. Some love a high full cheek or use transplanted fat to fill out that area. Others think a face-lift that doesn’t address the eye area is incomplete. And some aim to deliver simply a tight neck and a defined jaw line. Dr. Hamra’s guide advocates the composite face-lift, a fairly aggressive surgery that also addresses hollow eyes and lifts cheeks vertically. (If readers can get past the book’s dollops of self-promotion, its descriptions of post face-lift issues prove useful.)
Dr. Constantian, for his part, wrote a new textbook “Rhinoplasty: Craft and Magic” because he feels the “basic ideas of how to fix a nose aren’t correct.” Two misconceptions get surgeons started on the wrong foot, he said. First, the mistaken notion that if a surgeon fashions a good-looking skeletal shape, skin draped over it will “take on the nose shape.”
Not so. The skin of the lower nose “won’t necessarily shrink to the shape the surgeon wants,” Dr. Constantian said.
“We were taught if you just change one area in the nose, nothing else changes,” he added. But “if you reduce the tip cartilage to make it prettier, you can also weaken the ability of the cartilage to support the nostrils,” he said. So he compensates for that weakness.
But some surgeons think impaired breathing is an acceptable trade-off for aesthetic improvement. “Breathing worse after a rhinoplasty is so common that I’ve heard surgeons say on panels at meetings that they expect it to happen, they tell their patients it will happen,” Dr. Constantian said. “I don’t think it should ever happen.”
Dr. Joseph M. Gryskiewicz, the vice president of the Rhinoplasty Society, a nonprofit educational organization for surgeons, wrote in an e-mail message, “Only a sadist would say breathing compromise is O.K.”
This article is from www.nytimes.com By CATHERINE SAINT LOUIS
Published: October 28, 2009
These days, there’s such a critical mass of plastic surgery patients dissatisfied with their results that many doctors market secondary surgeries, or re-dos. It’s not hard to find surgeons’ Web sites that describe in detail how an asymmetrical nose job or an unsatisfactory face-lift can be righted. Last month, Dr. Sam T. Hamra, a plastic surgeon in Dallas, published “The Facelift Letdown: When Results Don’t Meet Expectations” to arm patients with information so they can better articulate their desires to their doctors and avoid postsurgery discontent.
No organization tracks how many procedures are done to correct cosmetic work. (Muddying the situation is the fact that some doctors tweak their own work if it falls short of the patient’s goals and that some complications call for immediate reoperation, like a hematoma, or a collection of pooled blood, beneath a closed incision.)
In this still-shaky economy, cosmetic surgery is down, and revisions for unhappy patients are included in that slump. But doctors who do a lot of revision face-lifts and nose jobs (two common redos) say demand for those operations is still strong.
Reasons vary, depending on the procedure. Rhinoplasty, for instance, is tricky because surgeons can’t control healing or how good the building materials are. Cartilage can be too thick or too flimsy; skin draped over a newly fashioned nose structure might not shrink to the shape the surgeon wants.
“It’s a difficult operation with a lot of variables,” said Dr. James C. Grotting, the editor of the textbook “Reoperative Aesthetic and Reconstructive Plastic Surgery.” “So even in the best of hands, people who only do rhinoplasty,” he said, there is still “a revision rate of up to 20 percent.” Some of the best fix-it nose doctors are sober about the limitations. Dr. Mark B. Constantian, a nose specialist in Nashua, N.H., whose practice is 75 percent revisions, said rhinoplasty is unique in that “you can lose ground every time.” With other kinds of plastic surgery, patients “are not worse off than when they started.”
Some doctors refuse to tackle secondary or tertiary rhinoplasties, and sometimes patients seeking these operations get unfairly labeled as “a fussy neurotic group,” Dr. Constantian said.
He pinpointed four reasons for dissatisfaction: breathing is worse, which can happen if a doctor doesn’t compensate for aesthetic changes; postoperative deformity that patients don’t like (perhaps removing a bump leaves the patient’s nose crooked); the patient never reached the original goal; and last, the patient got the requested change but now finds it unacceptable. “After, they feel they lost a familial or ethnic characteristic, and ask, ‘Can you do something to put my nose back to what it was?’ ” he said.
One of Dr. Constantian’s revision patients, a nurse in New Hampshire, got her first rhinoplasty in 2004 to fix her nose’s too-wide tip and a hanging columella, the tissue on the underside between the nostrils. As the post-operation swelling subsided, “Everyday I would look and wait for changes,” said the nurse, who asked to remain anonymous. But the nose tip “was still wide” and the columella didn’t look “touched at all.” She searched on Google for nose specialists and found Dr. Constantian. Today her profile is straight, her columella no longer hangs, and she breathes better. “My breathing was never a problem until after the first surgery,” the nurse said.
Sometimes earnest miscommunication between patient and doctor is at the heart of the matter. “What the patient is seeing in their mind is hard to describe to the doctor,” said Dr. Jack P. Gunter, who devotes 40 percent of his nasal-surgery practice in Dallas to redos. “Patients will say, ‘I just want a little taken off.’ How much is a little?” Other doctors sweet-talk patients into thinking the perfect nose or face-lift is within reach, leading to discontent. “People are marketing things they cannot achieve,” Dr. Gunter said.
These days advertising creates unrealistic expectations, said Dr. Grotting, whose practice is in Birmingham, Ala. The idea that a procedure can be quick, simple, painless, “all of these catchphrases are heavily marketed to plastic surgery patients,” he said.
When it comes to plastic surgery, Dr. Hamra said, the “customer is always right.” A gynecology patient isn’t the one to determine if she wishes to spend less money to remove fewer of her uterine fibroids. A plastic surgery patient, however, can choose a minimally invasive face-lift instead of a more complete one, said Dr. Hamra, who favors comprehensive face-lifts that address upper cheeks and foreheads. If one surgeon won’t give him what he wants, the patient finds one who will.
Celebrity cases of too many face-lifts overshadow a common problem these days: paying thousands for small improvements that don’t last.
“In face-lifts, you see undercorrections,” said Dr. James M. Stuzin, a plastic surgeon who specializes in face-lifts in Miami and does a “big volume of redos.” Mini face-lifts, he said, require “little recovery,” but have “little longevity.” He also cautions that some surgeons who do only occasional face-lifting “don’t reconstruct the internal anatomy, and that has more longevity.”
In other words, you get what you pay for. “I’m seeing more people who have gone to clinics where price is a major concern for them going there, and often they are dissatisfied with the result,” said Dr. Stuzin, a past president of the American Society for Aesthetic Plastic Surgery. “Instead of muscle work, they are oversuctioning the neck, so the neck looks skeletal.”
Furthermore, not every plastic surgeon tailors his work to each face, but instead “do it the same way every day, and that doesn’t work for faces,” said Dr. Mark E. Richards, a plastic surgeon in the Washington, D.C., area. Patients have sought out Dr. Richards for revision face-lifts ever since Linda Tripp announced on TV that he redid her botched face-lift in 2000.
Other experts caution to be wary of the doctor whose technique is stuck in the dark ages. “There are still a lot of surgeons who just redrape the skin — that’s it,” Dr. Grotting said.
For decades, doing face-lifts hasn’t been about simply pulling the skin toward the ear. At the very least, underlying layers of tissue and fat should be repositioned; some doctors also try to restore the curves and volume lost to aging.
Lately, Dr. Richards says that he has found that many of his unhappy patients are missing “cheek curves.” Pulling the connective and fatty tissue layers just below the skin “doesn’t make an attractive face,” he said. “It just makes a tight face.”
Surgeons’ philosophies vary widely, so it’s crucial to meet with a few to ascertain which one will best achieve your goals. Some love a high full cheek or use transplanted fat to fill out that area. Others think a face-lift that doesn’t address the eye area is incomplete. And some aim to deliver simply a tight neck and a defined jaw line. Dr. Hamra’s guide advocates the composite face-lift, a fairly aggressive surgery that also addresses hollow eyes and lifts cheeks vertically. (If readers can get past the book’s dollops of self-promotion, its descriptions of post face-lift issues prove useful.)
Dr. Constantian, for his part, wrote a new textbook “Rhinoplasty: Craft and Magic” because he feels the “basic ideas of how to fix a nose aren’t correct.” Two misconceptions get surgeons started on the wrong foot, he said. First, the mistaken notion that if a surgeon fashions a good-looking skeletal shape, skin draped over it will “take on the nose shape.”
Not so. The skin of the lower nose “won’t necessarily shrink to the shape the surgeon wants,” Dr. Constantian said.
“We were taught if you just change one area in the nose, nothing else changes,” he added. But “if you reduce the tip cartilage to make it prettier, you can also weaken the ability of the cartilage to support the nostrils,” he said. So he compensates for that weakness.
But some surgeons think impaired breathing is an acceptable trade-off for aesthetic improvement. “Breathing worse after a rhinoplasty is so common that I’ve heard surgeons say on panels at meetings that they expect it to happen, they tell their patients it will happen,” Dr. Constantian said. “I don’t think it should ever happen.”
Dr. Joseph M. Gryskiewicz, the vice president of the Rhinoplasty Society, a nonprofit educational organization for surgeons, wrote in an e-mail message, “Only a sadist would say breathing compromise is O.K.”
This article is from www.nytimes.com By CATHERINE SAINT LOUIS
Published: October 28, 2009
Wednesday, October 28, 2009
Special Offer from Rhinoplasty Specialist
Dr. Jennifer Levine, famous Rhinoplasty specialist has revealed a great offer on facial surgery procedures for everyone. Available on October 29, 2009, this offer is valid between 4 P.M. and 7 P.M. a discount of 15% will be given on cosmetic procedures like Botox, Juvederm, Perlane, Restylane, Radiesse, Clinique Medical, Chemical Peels and Revale Skin. If you bring along a friend, these facial and skin care treatments can be taken at 20% off the original price. Free supply of Latisse (retail price: $160) can also be availed by the first 10 people to take treatment.
As the web portal of an eminent New York cosmetic surgeon, Dr Jennifer Levine provides all the essential facts and guidance needed to make informed medical choices. Not only is Dr Levine a certified Facial Plastic Surgeon but also one of the few female Plastic Surgeon New York
The home page of this informative site is quite appealing and offers easy access to information about various treatments like Blepharoplasty Surgery, Rhinoplasty Surgery NY and even facelift surgery ny. Specializing in face and neck lift, Dr Jennifer Levine also conducts eyebrow lift surgery, Chin Implants NY and cheek implants.
Every procedure is conducted with great care and minimal invasion. Unlike many otherBlepharoplasty NY and Rhinoplasty NY surgeons, Dr Jennifer Levine Best rhinoplasty surgeondiscourages the surgical look through stylized treatments. Subtle changes are made in the individual’s facial features to enhance their beauty and proportion. The focus is on natural changes rather than excessive surgical procedures.
Patients can read more about each kind of procedure in the different sections of Dr Levine’s website, drjenniferlevine.com. The main categories include face and neck lift surgery, nasal surgery, eyelid lift, brow and forehead lift, chin and cheek implants. A separate section informs people about the treatment for reducing wrinkles and blemishes to get a youthful, supple and fresh appearance.
Apart from New York patients, drjenniferlevine.com also provides services to out of town patients. Fixing appointments for specific, personalized treatment is very simple through this site. They offer latest and innovative technology for all procedures of facial plastic surgery,Rhinoplasty manhattan, face and neck lift, and Blepharoplasty NY. Previous successful cases can also be viewed on drjenniferlevine.com to compare the facial problems of before with the rejunivated and corrected features after surgery.
Visit them at http://www.drjenniferlevine.com
240 East 79th Street
New York, NY 10021
Telephone: 212.517.9400
Facsimile : 212.585.2604
Tuesday, October 20, 2009
India Offers Rhinoplasty
Medical tourism in India offer Rhinoplasty in Goa combined with a first class holiday for what you would expect to pay only for the surgery back at home.
With high success rate of cosmetic surgery and better sunshine and weather has made people across the globe to come to India for getting medical care, not to forget the cost benefits and quality at par with international standards. Rhinoplasty in Goa India is done based upon dependable international standards that are comprehensively applied by surgeons and doctors, all of whom been formally trained in the UK or USA. Medical tourism in India aims to be the world leader in organized international cosmetic surgery holidays at Goa and have invested considerable time and money in ensuring that you receive nothing other than the best, most affordable quality surgical care possible, in the most relaxing environments, where you are fully looked after by our professional staff.
Rhinoplasty, otherwise known as nose job is a surgical procedure used to sculpt the nose to improve its original shape and size. It is an elective surgery used to modify nasal tip, to reduce the dorsal hump, to narrow nostrils, to reduce the width of the nose and to make other such nasal corrections. Each face has its own proportions, volumes, angles and outlines and Rhinoplasty can only tweak the features of one's face to make one's appearance better. The procedure is generally done on an outpatient basis and takes around two hours for the procedure to be completed. Since incisions are made inside the nose, only light scars are left after surgery which will fade in about two weeks time. The patient will not experience severe pain after surgery and even that will be compensated through medications
Rhinoplasty calls for the skill of the plastic surgeon. India has got both technology and skilled doctors who have successfully performed Rhinoplasty in India at a cost which is less than half when compared with western countries. Rhinoplasty in Goa India is provided at some of the leading organizations in the world providing high quality cosmetic surgery by qualified and experienced American and British board certified surgeons working in state of the art facilities. The surgery is combined with a luxurious stay in a beautiful resort environment of Goa- the perfect place to fully relax, recover and recuperate body and mind before returning home. Beautiful Goa India has a reputation that precedes itself as far as medical tourism is cornered. With skillful surgeons, rock-bottom prices, and up-to-date technology, India is an easy favorite for many medical tourism travelers; especially those looking for beautifying procedures.
To get more info on Rhinoplasty in Goa India visit us at www.tour2india4health.com. Or mail at enquiry@tour2india4health.com or you can call us at +91-9371136499, +91-9860755000
Friday, October 16, 2009
Current Trends in Rhinoplasty : An Expert Interview with Sherrell J. Aston MD
Rhinoplasties are increasingly popular procedures. A complex procedure, the rhinoplasty has in recent years seen changes of opinion in how this surgery should be performed, such as more attention to protecting or enhancing architectural integrity. Medscape's Pippa Wysong spoke to Sherrell J. Aston, MD, who offered his thoughts on the state of the art in rhinoplasty. Dr. Aston is Director and Chairman of the Department of Plastic Surgery at Manhattan Eye, Ear and Throat Hospital in New York, NY. He is also Professor of Plastic Surgery at the New York University School of Medicine, New York, NY, and is certified by the American Board of Surgery (ABS) and the American Board of Plastic Surgery (ABPS).
Medscape: Rhinoplasties are becoming more popular. Why is this, and who is having all of these rhinoplasties?
Dr. Aston: Most rhinoplasties are performed to change the cosmetic appearance of the nose. Most are performed in teenagers and young adults, but increasing numbers have been performed on people ranging from their 30s to their 60s. Breathing problems are frequently corrected during rhinoplasty.
Medscape: Are women still the main patient population for rhinoplasties?
Dr. Aston: Yes; however, about 15% of the noses in my practice belong to men. The incidence of men having rhinoplasties is a little higher than the incidence of men having facelifts. A large percentage of men who want rhinoplasties are in their late teens and early 20s. In men we perform rhinoplasties at a slightly older age than we do in women because a boy's face matures a little later.
Medscape:People might ask their surgeons whether it's possible to have a limited procedure, eg, take away the bump or change the tip. Is that realistic?
Dr. Aston: Only a small percentage of noses will look good with a limited procedure. The appearance of the nose depends on the relationship between all of the parts. If you change the tip, eg, make it smaller, it reduces some of the tip support and has the potential to make the profile look taller. On the other hand, if you just take a bump off the nose without touching the tip, it's possible that the tip will look bigger than it did before. When you alter one area, it influences the appearance of other areas of the nose.
Medscape: Are there any exceptions?
Dr. Aston: Yes; some patients have small bumps on their profiles (a thin tip with good projection), and you can just sand down the bump. Some noses have wide tips with good tip projection, and the patient's profile won't be reduced. A small number of patients don't need profile reductions or tip reductions, and you can do limited procedures. Today's rhinoplasty is more conservative than it was years ago.
Medscape:In what ways is rhinoplasty more conservative these days?
Dr. Aston: Today it's important to maintain architectural integrity because noses change over time. Twenty years after surgery, noses don't look the way they did 5 years after surgery. The skin sleeve of the nose eventually gets thinner. When I say skin, I'm including the fat layer and muscle overlying the cartilage and bones. Many rhinoplasties that were done 30-40 years ago and looked good a year after surgery, don't look as good today because less attention was paid to preserving architectural integrity.
Medscape:Preserving architectural integrity -- is that a state-of-the-art message?
Dr. Aston: Absolutely. State of the art is maintaining architectural integrity in both the bony and cartilaginous framework of the nose. In the patient lacking natural architectural integrity of the nose, we add it by borrowing cartilage from the septum, a rib, or possibly from the ear.
Medscape: What are some ways to preserve architecture? Does this commonly need to be done?
Dr. Aston: Yes, even in routine rhinoplasties. A spreader graft is often performed to maintain the dorsal lines of the nose. It maintains support for breathing in the midvault, gives an aesthetically pleasing contour line, and prevents a pinched look in the middle portion of the nose. We'll add strut grafts to the columella to maintain support of the tip and to give and maintain tip projection. Plus, we use various small cartilage grafts within the tip of the nose to give contour. The goal is to have the nose look normal, and function well.
Medscape:Is it possible to operate on the nose without leaving scars?
Dr. Aston: First, there are 2 basic types of rhinoplasties. One is closed or endonasal rhinoplasty. Incisions are made inside the nose to release the nose from its architectural framework, so one can work on the tip cartilage (the cartilage in the midvault of the nose), the nasal bones, and the septum. In my practice, a vast majority of rhinoplasties are performed with the closed technique. The second technique is open rhinoplasty, which requires an incision on the columella. The open rhinoplasty is indicated when the anatomy of the nose is more complex. It is also used in secondary rhinoplasties in which the procedure requires more direct exposure to the tip cartilage than you can get with a closed approach. You can obtain exposure to the nasal anatomy with either technique.
Medscape:Isn't open rhinoplasty more common than closed?
Dr. Aston: Probably, although closed is starting to regain ground. Although open rhinoplasty gives more direct exposure to the nasal anatomy, it leaves a visible scar. In most cases the scar heals well, but this is not always the case. In the past 20 years, the emphasis in plastic surgery residencies has been on open rhinoplasty, partly because you can see the anatomy more easily than with closed rhinoplasty. With closed rhinoplasty you need good 3-dimensional thinking to understand the anatomy and how the changes that you make will look afterward. Some noses have unusual anatomic situations that make open rhinoplasty the preferred technique. Personally, I think a lot of open rhinoplasties would be better if performed closed. Closed rhinoplasties take less time to heal. Open is more invasive and has more swelling.
Medscape: How do you make the tip of the nose look smaller?
Dr. Aston: Traditionally, making the tip smaller involved removing a portion of the tip cartilage. Today, a large number of tips are made smaller by removing very little of the tip cartilage -- sometimes none. Instead, you resculpt, reshape, and reposition the tip cartilage. For instance, if you have a broad bulbous tip, and the alar cartilages don't meet at the midline, you can remove small parts of the cartilages, but also change the angle of the tip cartilage so that the domes are made more acute. You can suture the domes of the 2 cartilages together to reposition them and make the tip smaller, which also makes the tip more triangular in shape and provides a more desired contour. Simply resecting cartilage in many tips won't do that. Many noses require cartilage grafts placed in the tip to support and project the tip. In some noses you actually make the nose look smaller by placing the grafts in such a way that it increases the tip projection, and supports the sidewalls. There are numerous options.
Medscape: What happens to the skin of the nose when you make the cartilaginous and bony framework smaller?
Dr. Aston: The skin of the nose contracts to conform to the bone and cartilage underneath. Removing skin has no place in routine cosmetic rhinoplasty. The scars would be unacceptable. You should leave the skin and let it shrink down. Skin type and thickness play a huge role in the final result.
Medscape: What's done to make breathing better with a rhinoplasty?
Dr. Aston: It depends on the etiology of the breathing problem. Repair of a deviated septum is common. If patients present with compromised valves, spreader grafts are used to maintain the internal valves of the nose. Sometimes internal valves could become compromised as part of the reduction rhinoplasty, but spreader grafts keep them open. Not infrequently, we alter the inferior turbinates to help open up the airway. Some noses need cartilage grafts to support the nasal tip and prevent the nostrils from collapsing.
Medscape: What does it mean to break the nose during rhinoplasty? Is it necessary?
Dr. Aston: It's necessary in probably 90% of rhinoplasties. When you lower the profile, you usually need to reduce the width of the base of the nose. A lateral osteotomy divides the ascending process of the maxilla on the sides of the nose so that you can adjust the base of the nose. If you lower the profile and don't narrow the sidewalls, then it will look too wide. Osteotomies can lead to bruising, but are much less traumatic than they were years ago.
Medscape: Do you have any general tips for physicians with regard to follow-up of rhinoplasty patients?
Dr. Aston: All noses take a minimum of 1 year for the swelling to go down. That doesn't mean that the nose doesn't look good 2 weeks after surgery, but refinements in the appearance occur over time. In patients with thicker skin it can take longer. It's important to convey this to patients.
Medscape: You've given everyone a lot to think about. Thanks for taking time to speak to Medscape.
SOURCE : medscape.com
Monday, October 12, 2009
The Miss Plastic contest finals take place in Hungary
The Miss Plastic contest is a beauty contest with a difference: only those who have had plastic surgery can take part. Indeed, several of thh participants have been thrown out of other contests after it was found that they were less natural than their competitors.
Fun though the whole idea of the Miss Plastic contest is it's not really about the women or their looks at all. It's a showcase for the skills of the plastic surgeons. For example, it's isn't how breasts look in a swimsuit or an evening gown that excites the judges. It's whether there are any visible scars to betray the augmentation. As might be imagined, competition to be a judge is fierce given the detailed examinations of the contestants which are necessary.
As well as fun the Miss Plastic contest is also amusing: the at one time front runner is currently confined to a wheelchair as a result of her surgery. No, nothing went wrong with the actual surgery:
Alexandra had just got through the breast examination stage - where the judges had congratulated her surgeon, Dr Tamas Rozsos, on the lack of any surgical scars.
She toppled over on the catwalk and tore a ligament in her foot. Onlooker Laszlo Feher said: 'Everyone was admiring her bodywork and then she started to topple - no-one was near enough to reach her and she fall badly. She was taken to hospital by ambulance.'
A friend said: 'She had not got used to the extra weight on top and her new hair extensions got in her eyes - she just lost her balance and tore a ligament in her foot badly.'
Not, perhaps, the very finest advertisement for plastic surgery.
SOURCE: www.examiner.com
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